Standard Gold + Vision + Adult Dental
Gold · PPO · Ambetter of Oklahoma · Oklahoma
At age 40 it costs between $636.22 and $765.82 a month before any subsidy, depending on which county you live in — a marketplace plan is priced per rating area, not per state.
What CMS publishes about it
| Plan ID | 62505OK0130021 |
|---|---|
| Insurer | Ambetter of Oklahoma |
| Metal level | Gold |
| Plan type | PPO |
| Standardised design | Design 1 — a plan CMS defined the benefits of, so it can be compared like for like |
| Deductible (individual) | $2,000 |
| Deductible (family) | $4,000 |
| Drug deductible | Included in the medical deductible |
| Most you could pay in a year | $8,200 |
| Family maximum | $16,400 |
| Primary care visit | $30 |
| Specialist visit | $60 |
| Emergency room | 25% Coinsurance after deductible |
| Inpatient stay | 25% Coinsurance after deductible |
| Generic drugs | $15 |
| Preferred brand drugs | $30 |
| Specialty drugs | $250 |
| Adult dental included | Yes |
| Child dental included | No |
| Share of premium buying essential health benefits | 95.75% |
| Network directory | Who is in network |
| Summary of benefits | Summary of benefits and coverage |
| Drug list | Formulary |
| Customer service | 1-833-492-0679 |
Where it is sold, and what it costs there
43 counties. The premium is the price before any tax credit; what you pay depends on your income.
| County | At 21 | At 30 | At 40 | At 50 | At 60 |
|---|---|---|---|---|---|
| Canadian County | $497.84 | $565.03 | $636.22 | $889.12 | $1,351.10 |
| Cleveland County | $497.84 | $565.03 | $636.22 | $889.12 | $1,351.10 |
| Lincoln County | $497.84 | $565.03 | $636.22 | $889.12 | $1,351.10 |
| Logan County | $497.84 | $565.03 | $636.22 | $889.12 | $1,351.10 |
| McClain County | $497.84 | $565.03 | $636.22 | $889.12 | $1,351.10 |
| Oklahoma County | $497.84 | $565.03 | $636.22 | $889.12 | $1,351.10 |
| Creek County | $502.31 | $570.11 | $641.94 | $897.11 | $1,363.24 |
| Okmulgee County | $502.31 | $570.11 | $641.94 | $897.11 | $1,363.24 |
| Osage County | $502.31 | $570.11 | $641.94 | $897.11 | $1,363.24 |
| Rogers County | $502.31 | $570.11 | $641.94 | $897.11 | $1,363.24 |
| Tulsa County | $502.31 | $570.11 | $641.94 | $897.11 | $1,363.24 |
| Wagoner County | $502.31 | $570.11 | $641.94 | $897.11 | $1,363.24 |
| Adair County | $519.19 | $589.26 | $663.51 | $927.25 | $1,409.04 |
| Alfalfa County | $519.19 | $589.26 | $663.51 | $927.25 | $1,409.04 |
| Atoka County | $519.19 | $589.26 | $663.51 | $927.25 | $1,409.04 |
| Blaine County | $519.19 | $589.26 | $663.51 | $927.25 | $1,409.04 |
| Caddo County | $519.19 | $589.26 | $663.51 | $927.25 | $1,409.04 |
| Carter County | $519.19 | $589.26 | $663.51 | $927.25 | $1,409.04 |
| Cherokee County | $519.19 | $589.26 | $663.51 | $927.25 | $1,409.04 |
| Choctaw County | $519.19 | $589.26 | $663.51 | $927.25 | $1,409.04 |
| Cotton County | $519.19 | $589.26 | $663.51 | $927.25 | $1,409.04 |
| Dewey County | $519.19 | $589.26 | $663.51 | $927.25 | $1,409.04 |
| Garvin County | $519.19 | $589.26 | $663.51 | $927.25 | $1,409.04 |
| Grant County | $519.19 | $589.26 | $663.51 | $927.25 | $1,409.04 |
| Greer County | $519.19 | $589.26 | $663.51 | $927.25 | $1,409.04 |
| Haskell County | $519.19 | $589.26 | $663.51 | $927.25 | $1,409.04 |
| Johnston County | $519.19 | $589.26 | $663.51 | $927.25 | $1,409.04 |
| Kingfisher County | $519.19 | $589.26 | $663.51 | $927.25 | $1,409.04 |
| Love County | $519.19 | $589.26 | $663.51 | $927.25 | $1,409.04 |
| Major County | $519.19 | $589.26 | $663.51 | $927.25 | $1,409.04 |
| Mayes County | $519.19 | $589.26 | $663.51 | $927.25 | $1,409.04 |
| McIntosh County | $519.19 | $589.26 | $663.51 | $927.25 | $1,409.04 |
| Muskogee County | $519.19 | $589.26 | $663.51 | $927.25 | $1,409.04 |
| Okfuskee County | $519.19 | $589.26 | $663.51 | $927.25 | $1,409.04 |
| Payne County | $519.19 | $589.26 | $663.51 | $927.25 | $1,409.04 |
| Pontotoc County | $519.19 | $589.26 | $663.51 | $927.25 | $1,409.04 |
| Pottawatomie County | $519.19 | $589.26 | $663.51 | $927.25 | $1,409.04 |
| Pushmataha County | $519.19 | $589.26 | $663.51 | $927.25 | $1,409.04 |
| Seminole County | $519.19 | $589.26 | $663.51 | $927.25 | $1,409.04 |
| Woods County | $519.19 | $589.26 | $663.51 | $927.25 | $1,409.04 |
| Comanche County | $581.96 | $660.51 | $743.73 | $1,039.36 | $1,579.41 |
| Le Flore County | $599.24 | $680.13 | $765.82 | $1,070.23 | $1,626.32 |
| Sequoyah County | $599.24 | $680.13 | $765.82 | $1,070.23 | $1,626.32 |
Open enrollment for 2026 coverage runs 1 November 2025 to 15 January 2026 in most states. Outside that window you need a qualifying life event — losing other coverage, moving, marrying, having a child — to enrol.
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Premiums, deductibles, out-of-pocket maximums and cost sharing are reproduced from the HealthCare.gov Qualified Health Plan landscape file published by the Centers for Medicare & Medicaid Services for plan year 2026. Nothing on this page is calculated by us. This is not a complete list of your options and it is not advice: to see every plan and to enrol, use HealthCare.gov or call 1-800-318-2596.